Background and Purpose: Infections are associated with poor outcomes in young people with ischemic stroke, particularly if they are hospital-acquired. However, the influence of infection on hemorrhagic stroke outcomes in a young population is less well characterized. Methods: We conducted a single-center retrospective analysis of a prospectively collected stroke registry, for patients, aged 18-45, admitted with hemorrhagic stroke of any type from 01/2008 to 03/2015. We reviewed charts for study variables, including patient characteristics, risk factors, and hospital-acquired infections (HAI) or infections present on admission (POA). Poor outcome was defined as modified Rankin score of 3-6 at time of discharge. We compared patients with HAI and infection POA to those without an infection. Results: Of the 219 hemorrhage cases in young adults, 31 (14%) had an infection POA, and 65 (29.7%) had a HAI. As shown in the table, patients who had a HAI and a POA infection had higher baseline NIHSS than those without an infection. In the unadjusted analyses, POA infections (OR = 2. 96, 95%CI: 1.91-4.58) and HAI (OR= 6.51, 95%CI: 4.06 - 10.44) are associated with poor mRS on discharge for hemorrhagic stroke. Adjusting for NIHSS, the relationship between POA infections and poor outcome is no longer significant (OR = 1.45, 95%CI: 0.34- 6.27) while HAI remains associated with poor outcome (OR= 6.73, 95%CI: 2.22 - 20.41). In SAH only patients, after adjusting for NIHSS, HAI remains associated with poor outcome (OR = 21.61, 95%CI: 3.35 - 139) while POA infections are not associated (OR = 3.01, 95%CI: 0.294 - 30.8). In ICH only patients, after adjusting for NIHSS, neither HAI (OR = 3.18, 95%CI: 0.656 - 15.4) nor POA infections (OR = 2.19, 95%CI: 0.334- 14.3) are associated with poor outcomes. Conclusions: In our single-center study, HAI, but not infections POA, were associated with poor outcomes in young adults with SAH. This relationship was not seen in patients with ICH.
Background and Purpose: Sepsis has been identified as a risk factor for stroke, however, the underlying mechanisms remain unclear and risk factors that may predispose a patient to an increased stroke risk post-sepsis are unknown. The study aims to identify risk factors associated with post-sepsis stroke and subsets of the population that are most vulnerable to stroke after sepsis. Methods: The 2007 - 2009 California State Inpatient Database from the Health Care Utilization Project (HCUP) was used. Patients who were over the age of 18 and hospitalized with sepsis, defined by ICD-9 codes, were included. Patients who died during their sepsis hospitalization were excluded. The outcome of interest was a primary diagnosis of stroke, including ischemic and hemorrhagic, as defined through ICD-9 codes. Associations between risk factors and stroke were analyzed using multivariable logistic regression. A composite risk score was generated to assess the accuracy of prediction among the post-sepsis population. Results: Of the 114679 patients with diagnosis of sepsis, 0.5% (N=572) had a primary diagnosis of stroke within a year of their sepsis hospitalization. Significant predictors for stroke are listed in Table 1. A score was generated from these risk factors with points assigned based on beta coefficients. The ROC for the score is 0.6840. As the composite score increases, the risk of stroke increases (OR=1.46, 95% CI 1.40-1.53 for each point increase in the score). Post-sepsis patients with a score greater than or equal to 1 (N=35773) have the highest prevalence (prevalence = 31.19%) and are more likely to have a stroke. (OR= 3.18, 95% CI 2.69, 3.76) Conclusion: Independent risk factors for stroke after sepsis include valvular diseases, congestive heart failure, coagulopathy, lymphoma, peripheral vascular diseases, pulmonary circulation disorders, and renal failure.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.